Are doctors allowed to do this under OHIP?

[rfdrfd]

I have a question about a recent situation that my relative asked me about. He was at his GI Specialist, and he needed to book a Colonoscopy appointment. (where they stick a camera up your u know what)

The secretary told him that if he can pay a $100 fee, he would be able to get an appointment in end of November. If he couldn't pay, then the next available Colonoscopy would be in May 2007 sometime. Secretary told him that the $100 is not for the doctor, but is to pay for the room and equipment at the hospital that this examination was going to take place.

So, hoping to find out earlier if his illness is serious or not, he of course paid the $100 fee, and received a receipt that stated "For Colonscopy examination $100.00"

Is this a standard practice? Can Specialists charge patients to get an earlier appointment? Is this allowed? It seems like if one cannot afford the $100, then one would have to wait a longer time. Which to my understanding is opposite to the policy of OHIP and to general public accessible health-care, regardless of wealth, that Canada is well-known for. I also wonder how the amount of $100 was determined.

I sent an email to the OHIP (from their website), haven't received any replies back yet.

What do you think?

[MizTEcK]

im not sure but i would certainly not be happy if they did that to me

[BadDrafter]

I've run into the exact same situation except it was an endoscopy (through the mouth) the money I spent saved my life. The system has failed.:mad:

I would like to know what can be done about this.

[rfdrfd]

I've run into the exact same situation except it was an endoscopy (through the mouth) the money I spent saved my life. The system has failed.:mad:

I would like to know what can be done about this.


Thanks, good to know this actually happens elsewhere.

So do you think the dr. is actually lying about dates? And then somehow getting money off ppl to get an earlier date?

I mean, FULL is FULL right? Where do they magically get a date ?

[hightechfan]

Ohip does not care in some cases they get a cut.

[ahyue2]

This sounds fishy to me....

It sounds like somone has reserved a time/ date for people who are willing to pay?

I thought that the OHIP/ or the Canadian health care system is a single tier system, unlike the two tier systems else where....

Correct me if I am wrong though, was there a private clinic offering services for a fee that was recently opened in York Region??

[rfdrfd]

Ohip does not care in some cases they get a cut.

Oh that is disguisting !! I bet you are right.


So can I confront this issue with this doctor somehow? Whom can I throw at him to make him be weary ? College of Doctors?

[pfdude]

Most of these places are private clinics who just send a bill to OHIP for any services you use. It doesn't surprise me that they're offering expedited service at an extra cost.

Sucks about the camera up the bum. I've had the unfortunate experience of both the colonoscopy and endoscopy only for them to find nothing wrong. 2 years later, I'm getting worse.

[caliente]

This sounds fishy to me....

It sounds like somone has reserved a time/ date for people who are willing to pay?

I thought that the OHIP/ or the Canadian health care system is a single tier system, unlike the two tier systems else where....

Correct me if I am wrong though, was there a private clinic offering services for a fee that was recently opened in York Region??

The Canadian healthcare system may officially be single tier, but in reality it's a different matter. Where do you think Paul Martin, Stephen Harper, etc, go and how long do you think they wait? There have always been exclusive clinics.

I don't know about this particular doctor, but sometimes you can pay extra to get an earlier MRI scan. Sometimes an MRI will only be booked for x amt of hours of clinic/patient time and this may depend on the technicians. Also, an MRI might be shared with researchers depending on the hospital. Someone needs to pay for running the MRI machine and for the technician if the scan is done outside regular clinic hours.

[rfdrfd]

Most of these places are private clinics who just send a bill to OHIP for any services you use. It doesn't surprise me that they're offering expedited service at an extra cost.

Sucks about the camera up the bum. I've had the unfortunate experience of both the colonoscopy and endoscopy only for them to find nothing wrong. 2 years later, I'm getting worse.

I wish you the best, hope you are getting better soon

[Shaner]

Doesn't surprise me.

When are people going to give up on this idea of a fully public healthcare system and start embracing a more efficient semi-private system?

Our public healthcare system failed long ago and we now have an unofficial two tiered system. Perhaps instead of fighting what is already there, we should embrace it and try to make it work more efficiently.

Too many Canadians are dying because we insist on fighting for something that we already lost.

Our public health care system is never going to come back regardless of how hard we fight. Once you lose something, the government never gives it back.

[ji2o0k]

yeah the sad reality is that there is an "un-official" two-tiered system.

Our current health care system is in disarray. Go to an emergency room and look at the line-ups, the wait times and check out patients that need critical surgery but can't get it in time because of severe back-log.

Some people would rather pay for immediate services instead of waiting in agony or dying because of the long wait for surgery.

Some people go over to the States and pay for the surgery. Even if they can't afford it, they would rather be healthy and alive but poor then have some money but dying or in agony.

The current system doesn't work and something needs to be done.

[kingsley]

We have a war on public health care going on here in canada.

[dark169]

I've run into the exact same situation except it was an endoscopy (through the mouth) the money I spent saved my life. The system has failed.:mad:

I would like to know what can be done about this.

Sadly you would have been a statistic in a fully public system. Sad but true.

The current system is already taking the largest portion of our tax dollars and we have situations like this, increasing funding (see: taxes) hasn't worked. Personally I feel that telling someone they can't spend their hard earned money on their health has to be one of the stupidest canadian inventions of all time.

[Marlek]

I was curious, so I just spoke to my boss about this (ex-neurosurgeon and former chief of staff at a large hospital). He tells me that it's completely illegal to charge these types of user fees in Ontario.

OHIP will come down hard on this particular specialist if they find out.

[eelfliw]

Not sure if this is allowed or not but if I'm sick, I'll gladly pay $100 (or even $1000) to find out as fast as possible the cause and then find a cure. And if there's no cure, I'll have more time to prepare for the funeral.

A huge portion of my income already gets taken by the government to run the health care system. What's another $100?

[ritsbits]

I have a question about a recent situation that my relative asked me about. He was at his GI Specialist, and he needed to book a Colonoscopy appointment. (where they stick a camera up your u know what)

The secretary told him that if he can pay a $100 fee, he would be able to get an appointment in end of November. If he couldn't pay, then the next available Colonoscopy would be in May 2007 sometime. Secretary told him that the $100 is not for the doctor, but is to pay for the room and equipment at the hospital that this examination was going to take place.

So, hoping to find out earlier if his illness is serious or not, he of course paid the $100 fee, and received a receipt that stated "For Colonscopy examination $100.00"

Is this a standard practice? Can Specialists charge patients to get an earlier appointment? Is this allowed? It seems like if one cannot afford the $100, then one would have to wait a longer time. Which to my understanding is opposite to the policy of OHIP and to general public accessible health-care, regardless of wealth, that Canada is well-known for. I also wonder how the amount of $100 was determined.

I sent an email to the OHIP (from their website), haven't received any replies back yet.

What do you think?

If I were you, I would also ask (aka notify) the college of physicians and surgeons if this was typical practice or allowed... and incidentally name the physician and his location. These types of things are often done (free of charge) for family members and friends, to be honest... but charging the public like this shouldn't be done. chances are, some physicians bump off another patient, or start creating "pay slots" in their schedule to accommodate this.

just my two cents however :-0

[TapemanPL]

a couple people whom i know have had this done recently and every GI doctor they've seen charges a fee, but it's not like in your case where they charge you to get the test done before someone who doesn't pay, it was a flat $75 and that was it for everyone and no one was more of a priority than another

[TheOneBarton]

Is this a public clinic or private?

[Shaner]

Is this a public clinic or private?

Does it matter? What they did is just shy of extortion. Pay us money and we'll make your appointment tomorrow. Don't pay us money and we'll make your appointment 6 months from now.

That's illegal in the context described by the OP.

[tlamm]

I have no idea if its allowed or not. But I would not complain about it until well after the appointment. Last thing you want to do is piss off the doctor doing the exam.

[gilboman]

Personally I feel that telling someone they can't spend their hard earned money on their health has to be one of the stupidest canadian inventions of all time.

um...what are you talking about? live under a rock? of course canadians with money can get preferential treatment and faster service:confused:

[gman]

I have a question about a recent situation that my relative asked me about. He was at his GI Specialist, and he needed to book a Colonoscopy appointment. (where they stick a camera up your u know what)

The secretary told him that if he can pay a $100 fee, he would be able to get an appointment in end of November. If he couldn't pay, then the next available Colonoscopy would be in May 2007 sometime. Secretary told him that the $100 is not for the doctor, but is to pay for the room and equipment at the hospital that this examination was going to take place.

So, hoping to find out earlier if his illness is serious or not, he of course paid the $100 fee, and received a receipt that stated "For Colonscopy examination $100.00"

Is this a standard practice? Can Specialists charge patients to get an earlier appointment? Is this allowed? It seems like if one cannot afford the $100, then one would have to wait a longer time. Which to my understanding is opposite to the policy of OHIP and to general public accessible health-care, regardless of wealth, that Canada is well-known for. I also wonder how the amount of $100 was determined.

I sent an email to the OHIP (from their website), haven't received any replies back yet.

What do you think?


Do you know what the time of the day the 'express' is?
Would that be something which is not in normal hour?

My guess is OHIP only pays for the regular standard exam fee. If it is done in off hour, somebody needs to pay the extra of the OT of the room, equipment, staff, etc. OHIP does not pay that. Hence, somebody needs to pay the difference.

This is only a guess.

[rdx]

I think our health care system fails mostly because # of immigrants coming here for retirement and health care are more than those come here to work and pay taxes to fund the health system !

[rfdrfd]

I have no idea if its allowed or not. But I would not complain about it until well after the appointment. Last thing you want to do is piss off the doctor doing the exam.

I 10000% agree with you. I will investigate more after his appointment and hopefully the outcome of that is "nothing bad found in his gut".

[gman]

I think our health care system fails mostly because # of immigrants coming here for retirement and health care are more than those come here to work and pay taxes to fund the health system !

Do you have anything to support your 'theory'?

[rfdrfd]

I was curious, so I just spoke to my boss about this (ex-neurosurgeon and former chief of staff at a large hospital). He tells me that it's completely illegal to charge these types of user fees in Ontario.

OHIP will come down hard on this particular specialist if they find out.


Thanks ! Can you (or ask him) to point me to any OHIP statements online (hopefully) that states the rules around this? I need to read up more and prepare myself before I speak to their secretary, etc.

I'm not out to get any doctor, I am not that type of a person. I will do it professionally and respectfully. but when I hear something like this, if you are poor, you will wait longer for an appointment, being in Canada, that is just wrong in my books.

[Icedawn]

I have 2 med students at my house right now ...

their semi-informed take?

illegal and that you shoudl report it to the college.

http://www.cpso.on.ca/About_the_College/who_to_call.htm

my tip, talk to these people first, they have a vested interested in this and will be able to get you better information.

[rfdrfd]

Good discussion by everyone on our health care system. Yes, I do agree that there are parts of the OHIP that fails.

However, the main problem in this situation is, lack of education about the rules to the general public. Also, the system is not set up properly, to prevent fraud by patients and doctors.

Its like WSIB, people before did not know that employers MUST provide a safe workplace and that they can refuse work if they believe its dangerous. So lots of people got hurt or killed. Now, in 2006, more people know about the rules and rights of workers due to WSIB education.

Same with OHIP. If patients were told that Doctors can't charge you for speeding up an appointment that OHIP pays for, then doctors can't do this sort of thing so blantantly.

This reminds me of Dentists. I've been to many Chinese Dentists and what they do is, they get you to sign that Insurance claim form, BEFORE, they even do anything on you. So you have no idea how much they are going to charge you. They will max it out for sure, even if the actual teeth scaling wouldn't normally cost that much. Sure, insurance pays for it all, but then your limit gets used up extra fast. Then when it comes to the end of the year, you have none left.

Hence, I've actually purposely went to a non-Chinese dentist and found one that is honest and proper. He bills me after he shows me the bill. Then i submit to insurance.

See, if the OHIP billing system was set up better, less of these things would happen. We all need to be more educated.


Oh ya, this doctor is NOT Caucasian.

[rfdrfd]

Do you know what the time of the day the 'express' is?
Would that be something which is not in normal hour?

My guess is OHIP only pays for the regular standard exam fee. If it is done in off hour, somebody needs to pay the extra of the OT of the room, equipment, staff, etc. OHIP does not pay that. Hence, somebody needs to pay the difference.

This is only a guess.


His examination is Wednesday. I have to double check the time, but he didn't tell me anything special (like I have to wake up at 4am or stay late till 8pm). So I'm quite sure its just sometime at 9am-5pm

[rfdrfd]

I have 2 med students at my house right now ...

their semi-informed take?

illegal and that you shoudl report it to the college.

http://www.cpso.on.ca/About_the_College/who_to_call.htm

my tip, talk to these people first, they have a vested interested in this and will be able to get you better information.


Thank you very much. Great info and I definitely will talk to them. Its good to learn more anyways.

[rfdrfd]

I think our health care system fails mostly because # of immigrants coming here for retirement and health care are more than those come here to work and pay taxes to fund the health system !


Don't immigrants pay taxes too? Which is part of health care funding?

[aquariaguy]

Our healthcare system is hands down better than the US. IF you've ever lived in the US, you'll see the horrors that people have go to through. 45 million people are uninusured here. 30% of the colleagues of mine have no insurance and we're in a health profession! It costs Canada cheaper per capita than US. Actually US is 2.5x more expensive than any other country with universal health care. I hope Canada doesn't go thorugh the ****** health care system like US. It's like going backwards.

Just remember, if you piss your specialist off, it might end up screwing you over. OMD's are so powerful, if you don't like them, they tell you to take a hike than, but than who else will you see since they are buddy buddy with each other.

[LegiT]

Heh...my uncle did this. He had two choices, wait 4 months for the next available appointment in a hospital (not sure if it's a hospital or another clinic) or go to a special clinic which you've got to pay $60 upfront to do it within less than a week. He didn't pay the family doctor but the physician at the clinic...the New Brunswick Clinic across from where the old CanadasComputers was.

[BadDrafter]

When my mom came to this country in the 70s this kind of crap did not happen and she was an immigrant. Why can't we just revert to 1970s style healthcare? What is so different about now?

[stuff352]

Ask for a bill or reciept, i want to too know what the money is actually for.

[M@rk]

You can debate about public vs. private all you want, but what the doctor did is downright illegal, and goes against the very foundation of the Canada Health Act.

Report him!

[tlamm]

After the exam of course.

You can debate about public vs. private all you want, but what the doctor did is downright illegal, and goes against the very foundation of the Canada Health Act.

Report him!

[deep]

Several of my relatives and best friends are in the medical profession, and they are constantly getting things done for me. When we were told my son couldn't get a urology consult in Hamilton for 4 months, we called my brother in law. 2 hours later, the DOCTOR that was going to do the consult called us personally to make an appointment later that week.

Same thing with an ophthalmologist appointment and a sports injury consult for me.

I don't believe in the administrative powers of our health care system....and I consult for them, so I kind of know what I'm talking about (although I've barely scratched the surface of a few different areas)

[dark169]

When my mom came to this country in the 70s this kind of crap did not happen and she was an immigrant. Why can't we just revert to 1970s style healthcare? What is so different about now?

the costs have risen much faster then inflation. We could easily fund 70's style healthcare today, but not using modren tech. Provences didn't have dozens of mri machines, for one example

[dark169]

You can debate about public vs. private all you want, but what the doctor did is downright illegal, and goes against the very foundation of the Canada Health Act.

Report him!

mind backing that up with a source?
BTW the canada health act speaks to the provences not the doctors.

[dark169]

um...what are you talking about? live under a rock? of course canadians with money can get preferential treatment and faster service:confused:

I know that, and personally should I ever need to I would spend my money on any treatment I could get. What I have a problem with is people telling me that I can't / shouldn't.

I see it only took a page or 2 before someone mentioned the US system, but theres a dozen or more nations with better healtcare then us that allow semi-private care and no one mentions those.

I am interested in the legalies of the OP, doctors shouldn't be working out side the guidlines of the provence I think the fact he gave you a receipt leads to that what he's doing is either ok or in a grey area, if it was really a hush-hush situation it would ahve been cash under the table or the receipt would have been made out to read something like "admin charges" or something

[mok86]

Do you have anything to support your 'theory'?

there was an article similar to this in the metro talking about how ppl come here to get citizenship then leave and go back to work in their motherland and they come back here to retire..they dont have to pay taxes or they are taxed less (not entirely sure)...

http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&call_pageid=971358637177&c=Article&cid=1163371809165

[Icedawn]

mind backing that up with a source?
BTW the canada health act speaks to the provences not the doctors.

okay, not the GREATEST source, but still pretty good. Its the textbook I am using for my Medical Jurisprudence Law course I'm taking

Canadian Health Law and Policy, 2nd Ed. pg 26

"In addition to the criterion of "accessibility provided for in s.12, the CHA also seeks to ensure accessibility through ss.18 and 19 of the act. Respectively, these sections require provincial plans to prohibit "user charges" and "Extra billing in order to quality for federal contributions. A "user charge" is a charge made to a patient that the patient must pay out of his or her own pocket to cover a portion or all of the price of health services. "Extra-billing" is a concept closely related to user charges and occurs where a health provider is free to bill the patient or the patient's private insurance company in addition to billing the governmen tfor services provided to the pateint"

And here, the explicit Ontario provision since you're right, the CHA is grounded on the federal spending power and doesn't affect physicians directly.

Commitment to the Future of Medicare Act, 2004
http://www.e-laws.gov.on.ca/DBLaws/Statutes/English/04c05_e.htm#10.(1)

A physician or designated practitioner shall not charge more or accept payment or other benefit for more than the amount payable under the Plan for rendering an insured service to an insured person. 2004, c. 5, s. 10 (1).

[gman]

there was an article similar to this in the metro talking about how ppl come here to get citizenship then leave and go back to work in their motherland and they come back here to retire..they dont have to pay taxes or they are taxed less (not entirely sure)...

http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&call_pageid=971358637177&c=Article&cid=1163371809165

That is a big difference from:

I think our health care system fails mostly because # of immigrants coming here for retirement and health care are more than those come here to work and pay taxes to fund the health system !

Saying some (not all) immigrants can take down our health care system is giving too much credit to immigrants.

And, what you said can apply to non-immigrant who born here. They take adavantage of the cheaper education. Move to US. Pay US tax and come back to retire.

At least, the adult immigrant who works here took advantage of education somewhere else (Canada does not need to pay for that) and pays Canadian tax.

[bikechick]

Trust me, our system is much better than the one in the US. I work for a US company with a branch in Toronto and it's amazing the horror stories that you hear. One woman had a $6000 bill for 4 hours in the hospital. A man had a 15-page invoice for a 2 day hospital stay. They billed him for all the medication (aspirin X 1) and even the banana he had with his breakfast!

I think our system works alot better than most other places. I don't mind waiting for the routine tests but what I do object to is having to wait a month for heart surgery (I can complain about this because it actually did happen to me). The first surgery was a 5 day wait and the second was a month... If I had been in the US, I would have had it by the next day. Sure I would have paid an arm and a leg for it, but it would have been done.

As for the doctor's charges.... Definately something is not right. Keep the reciept and write a letter to the Doctors College, including a copy of all paperwork. Ask for someone to call or write back. Worst case, it prevents them from possibly scamming another person.

On the plus side, at least the tests get completed and he gets helped. Hope everything turns out okay.

[mtharvey]

The thing I wonder about is that I always go to doctor but he gets rid of me in 20 minutes. I have never had any preventative medicine ie checking for cholesterol or something. He always asks if my diet is good and I say yes. I want a doctor that nags about diet and exercise and lots of tests for cancer , etc.. And i think there are some shots that adults are supposed to have to prevent disease. If it was the USA, they'd be sure to do everything.

[chococrazy]

The thing I wonder about is that I always go to doctor but he gets rid of me in 20 minutes. I have never had any preventative medicine ie checking for cholesterol or something. He always asks if my diet is good and I say yes. I want a doctor that nags about diet and exercise and lots of tests for cancer , etc.. And i think there are some shots that adults are supposed to have to prevent disease. If it was the USA, they'd be sure to do everything.

Schedule a physical. Tell the doctor that you want to get tested for everything, including cholesterol.

Your doctor is not your mother. You know what you should and shouldn't eat, you know you should exercise... be an adult (?). You don't have to hear it from him/her!

If you don't like your doctor, get a new one.

[aquariaguy]

The thing I wonder about is that I always go to doctor but he gets rid of me in 20 minutes. I have never had any preventative medicine ie checking for cholesterol or something. He always asks if my diet is good and I say yes. I want a doctor that nags about diet and exercise and lots of tests for cancer , etc.. And i think there are some shots that adults are supposed to have to prevent disease. If it was the USA, they'd be sure to do everything.


Like the following poster mentioned, if you want him to check something, ask! If you want to check arthritis factors, just ask him and he'll send you for a blood test to check for those.

Btw, if you guys were in the US, and you didn't like your doctor, guess what, too bad. Your insurance company assigns you to one, and if you don't like it, well you'll have to drive quite a distance to find another one that's taken under the health plan you have. Yea, you could pay over $300/month if you want that "freedom." And even if you wanted to go to a specialist, it probaly won't even be covered under your insurance plan unless you pay a deductable. Since you have to see the PCP first anyways. And plus the insurance scams doctors in the US because they don't get paid fully for all their services.

Friends that have insurance here, have a $100 deductible everytime they see a doctor. Which is exactly why people get sick and don't go to the doctor. Plus the pharmaceuticals are way more expensive here.

[mtharvey]

Schedule a physical. Tell the doctor that you want to get tested for everything, including cholesterol.

Your doctor is not your mother. You know what you should and shouldn't eat, you know you should exercise... be an adult (?). You don't have to hear it from him/her!

If you don't like your doctor, get a new one.

Advertising works and so does face to face selling. I want to be reminded that i need to brush my teeth and look after my health. I just recently learned that trans fats and saturated fats are bad. I wont have a physical without a gun to my head. When i go swimming i change in the
changing rooms not out in open.

[chococrazy]

Advertising works and so does face to face selling. I want to be reminded that i need to brush my teeth and look after my health. I just recently learned that trans fats and saturated fats are bad. I wont have a physical without a gun to my head. When i go swimming i change in the
changing rooms not out in open.

Time to grow up.

A doctor's work is now "Face to face selling"? :lol: Man, just how old are you? Say hello to my new avatar :)

[Marlek]

Several of my relatives and best friends are in the medical profession, and they are constantly getting things done for me. When we were told my son couldn't get a urology consult in Hamilton for 4 months, we called my brother in law. 2 hours later, the DOCTOR that was going to do the consult called us personally to make an appointment later that week.

Same thing with an ophthalmologist appointment and a sports injury consult for me.

I don't believe in the administrative powers of our health care system....and I consult for them, so I kind of know what I'm talking about (although I've barely scratched the surface of a few different areas)

My bread and butter is the healthcare system (I design software to assist in the management of wait lists). At the moment there is zero accountability with respect to queue jumping. The physician and their secretary hold complete control over who is next - and generally they act responsibly in this respect. That said, preferential treatment can be done with impunity. In Ontario there is a relatively new system to allow for the reporting of wait times, but you would never get a red flag over someone getting in "too fast"... they are simply not reporting at that level of detail.

It should also be said that one of the biggest issues in the wait time continuum is how referrals are handled. There is simply no real, useful information to inform referring GPs who should receive their referral. Most offices refer to a particular specialist because they have always referred to them out of habit. They have no information to know that specialist X,Y,Z could see the patient in half the time. Most patients aren't aware that referrals to different specialists are even an option. As a result, you end up with huge disparities in waits to see specialists. And all the wait times you here people talking about? There are virtually no systems in place that track the wait to see a specialist. Everyone is simply talking about wait times from the date of decision to operate. Which is silly, because you can completely manipulate that wait by cutting down on the number of patients you see for initial consultation.

To the OP who asked if my boss could point to a specific bit of legislation... to be honest, he'd ask questions about the specific circumstances and I'd feel a bit silly saying it was for someone in an Internet forum... lol. As others have pointed out, you should probably contact the Ontario College of Physicians or OHIP directly.

[almostfreeman]

Doesn't surprise me.

When are people going to give up on this idea of a fully public healthcare system and start embracing a more efficient semi-private system?

Our public healthcare system failed long ago and we now have an unofficial two tiered system. Perhaps instead of fighting what is already there, we should embrace it and try to make it work more efficiently.




I will start embracing the more "efficient" semi-private system when you can provide some documeted evidence that such a system is indeed more efficient.

[dark169]

I will start embracing the more "efficient" semi-private system when you can provide some documeted evidence that such a system is indeed more efficient.

http://ucatlas.ucsc.edu/spend.php

its a little dated but you'll notic in the second graph that iceland, sweden, austalia and japan all spend about the same or less per captia and have higher life expectancy's. Of course it shows that looking to the US for answers is the worst idea, and of course semi-private advocates never looker there unless you listen to Jack Layton.

I'm sure theres more out there but I'm busy and it came up on the first page of a simple google.

[rdx]

there was an article similar to this in the metro talking about how ppl come here to get citizenship then leave and go back to work in their motherland and they come back here to retire..they dont have to pay taxes or they are taxed less (not entirely sure)...

http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&call_pageid=971358637177&c=Article&cid=1163371809165

This is exactly what I am trying to say. Don't get me wrong, I am an immigrant here as well, but just me and my wife working here and paying taxes. But I do know there are lot of families who came here with both sides of retired parents (4 people) and 2-3 kids. So, at most there are only two people in the work force and paying taxes in Canada, but our systems (all social systems, school, health, communitites, etc) have to support the whole family of 8-9 people. Those retired grandparents didn't work here nor paid taxes, those young ones will not able to pay taxes until they graduated from school (10-20 years later).

Worst senerio is that no one in this whole family is working and paying taxes in Canada as the dad is working overseas and claiming nonresidence. And when the kids grow up and educated by the Canadian education system, they go back and work in their home country or work in US. But 30 yrs later, come back and retire in Canada and enjoy the health care...........

I am just saying there is no way our system can support this in the long run as more and more immigrants coming and doing the same things (come here for retirement and education but not paying taxes). I guess that's why the Canadian government recently is disucussing to pass the new law for taxing those "citiizens" overseas income, who claim nonresidence.

[dark169]

And here, the explicit Ontario provision since you're right, the CHA is grounded on the federal spending power and doesn't affect physicians directly.

Commitment to the Future of Medicare Act, 2004
http://www.e-laws.gov.on.ca/DBLaws/Statutes/English/04c05_e.htm#10.(1)

A physician or designated practitioner shall not charge more or accept payment or other benefit for more than the amount payable under the Plan for rendering an insured service to an insured person. 2004, c. 5, s. 10 (1).

Thanks, I think the OP falls into the grey area that this provision leaves open as an insured service is the service that has the waiting list associtated with it.

[slowpoke]

Btw, if you guys were in the US, and you didn't like your doctor, guess what, too bad. Your insurance company assigns you to one, and if you don't like it, well you'll have to drive quite a distance to find another one that's taken under the health plan you have.

Interesting parallel to true socialized medicine where you are assigned a doctor based on your postal code (like in the Netherlands for example).

[gman]

Worst senerio is that no one in this whole family is working and paying taxes in Canada as the dad is working overseas and claiming nonresidence. And when the kids grow up and educated by the Canadian education system, they go back and work in their home country or work in US. But 30 yrs later, come back and retire in Canada and enjoy the health care...........

You cannot do that without breaking the law. If you leave your family behind, you cannot claim non-residence.

Anybody (immigrants or people who born here) can do the same thing. It is just immigrants can do that easier. My ex-colleague as a white canadian is doing exactly that except he is not married. But, he will come back when he retires.

[rfdrfd]

The thing I wonder about is that I always go to doctor but he gets rid of me in 20 minutes. I have never had any preventative medicine ie checking for cholesterol or something. He always asks if my diet is good and I say yes. I want a doctor that nags about diet and exercise and lots of tests for cancer , etc.. And i think there are some shots that adults are supposed to have to prevent disease. If it was the USA, they'd be sure to do everything.

I agree. Try seeing Naturalpathic Doctor. I went and they do all that and more. They look at my entire life history, family history and work on healing me. NOT just bandaid solutions like: Allergies? Take Claritin or Allergra. They think, we need to boost your immune system (via diet, vitamins, sleep, etc).

Naturalpathic dr. will spend at least 1hr with you, your wait time will be less than 10min. Because they really DO keep your appointment time. My family doctor, although I like him, keeps me waiting for 2 hrs, for a 10min session !!! KIcks me out right after. Now Naturalpathic dr. can only do sooo much, if the illness is serious, you do need a specialist. But for minor-medium illness, they are much better, and more caring than a 10min Family dr.

[BadDrafter]

But 30 yrs later, come back and retire in Canada and enjoy the health care...........


A lot can happen in 30 years, socialized medicine may not exist anymore and the Canadian population could be over 100 million by then.

[Bordello]

As a med student and someone working in a medical office with many specialists, including a gastroenterologist, I can tell you that it is not permitted. They are allowed to give preference to more urgent cases, but money should not be changing hands. This is beyond a question of ethics.

You should contact the Ontario College of Physicians and OHIP. This person needs their license revoked and slapped with a big ass fine.

Ask your GP to refer you to another GI specialist. This one seems pretty shady and not at all trustworthy.

[rfdrfd]

As a med student and someone working in a medical office with many specialists, including a gastroenterologist, I can tell you that it is not permitted. They are allowed to give preference to more urgent cases, but money should not be changing hands. This is beyond a question of ethics.

You should contact the Ontario College of Physicians and OHIP. This person needs their license revoked and slapped with a big ass fine.

Ask your GP to refer you to another GI specialist. This one seems pretty shady and not at all trustworthy.


Got it thanks. But what if the situation is, the dr doesn't have this date of the appointment schedulled to him, so he has to actually book an extra time, room, equipment to do this.

In that situation, can that Dr. offload the cost of arranging this extra day to the patient? $100 ?


I'm definitely going to investigate more on this, as I'm sure my relative is NOT the first $100 he's gotten. Doctors can't do that. In my scale of things, Doctors are regarded to be up there with integrity and helping people. Not trying to make a quick buck in cheating the system.

However, I have to wait till AFTER the examination because I don't want to piss of the doctor in anyway. And like someone else pointed, all the GI specialists know each other, and I'm sure they will tell each other about this patient that ratted them out.

[Bordello]

Got it thanks. But what if the situation is, the dr doesn't have this date of the appointment schedulled to him, so he has to actually book an extra time, room, equipment to do this.

In that situation, can that Dr. offload the cost of arranging this extra day to the patient? $100 ?
Doctors in Ontario are not allowed to directly bill patients anything that is covered by OHIP, even if there are extra costs incurred when treating a patient. If he charges you for something covered by OHIP, then it is considered private health care, which is still illegal in Ontario. The only things he is allowed to charge for colonoscopies is a no-show fee or a minimal fee for anesthesia (things OHIP doesn't reimburse him for). $100 in "special accomodation" costs doesn't count. What I just said may sound confusing or even contradictory, but he knows what he's doing is not permitted. Definitely contact the authority.

[rfdrfd]

Doctors in Ontario are not allowed to directly bill patients anything that is covered by OHIP, even if there are extra costs incurred when treating a patient. If he charges you for something covered by OHIP, then it is considered private health care, which is still illegal in Ontario. The only things he is allowed to charge for colonoscopies is a no-show fee or a minimal fee for anesthesia (things OHIP doesn't reimburse him for). $100 in "special accomodation" costs doesn't count. What I just said may sound confusing or even contradictory, but he knows what he's doing is not permitted. Definitely contact the authority.

Thanks. I thought so too. Even though I'm not a med student or dr, that is the way OHIP should be.

Now, get this, on the instructions sheet, it does state that if you do NOT tell us of a cancellation within 24hr, then a $100 fee will be charged. But they already charged and my relative paid already. So, doesn't look like this $100 is for that.

[aquariaguy]

I agree. Try seeing Naturalpathic Doctor. I went and they do all that and more. They look at my entire life history, family history and work on healing me. NOT just bandaid solutions like: Allergies? Take Claritin or Allergra. They think, we need to boost your immune system (via diet, vitamins, sleep, etc).

Naturalpathic dr. will spend at least 1hr with you, your wait time will be less than 10min. Because they really DO keep your appointment time. My family doctor, although I like him, keeps me waiting for 2 hrs, for a 10min session !!! KIcks me out right after. Now Naturalpathic dr. can only do sooo much, if the illness is serious, you do need a specialist. But for minor-medium illness, they are much better, and more caring than a 10min Family dr.


And these guys aren't covered under OHIP? They charge their own fees? Do they sell you vitamins too? I don't think they are overwhelmed by the amount of patients like GPs.

[rfdrfd]

And these guys aren't covered under OHIP? They charge their own fees? Do they sell you vitamins too? I don't think they are overwhelmed by the amount of patients like GPs.

Naturalpathic medicine are not covered by OHIP, since they have not been accepted into the main stream medicine yet, much like accupuncture. So yes, they have their own fee schedule. However, where I work, my extended health insurance covers it.

I went to the Robert Schad Naturopath School Clinic. Its the school clinic where 3rd and 4th yr students supervised by a Dr. sees you. Website: http://www.ccnm.edu/clinic/index.html

If you read their policies and goals, they are quite good and makes you feel a lot better than what general practicianers do in Ontario/Toronto.

They have their own shop that sells vitamins, but you can buy them anywhere at any drug store or natural food stores.

[jayk]

how about charging patients for not showing up to their appointments, or requiring forms to be filled out or getting sick notes?

Are these billable under OHIP?

Seems like it would make sense that they would be billable tho, cuz you're making use of the doctor's time, or wasting it in the case of not showing up to your appointment

[Bordello]

No, medical certificates (sick notes) are not covered by OHIP. That's why most clinics charge $10-$20 for them even though they take a whole 20 seconds to write.

Doctors do not bill OHIP for the visit if the patient doesn't show up, that's why they have a fee for no-shows, to make up for lost income (even though they charge much more than what they'd really make).

[aquariaguy]

how about charging patients for not showing up to their appointments, or requiring forms to be filled out or getting sick notes?

Are these billable under OHIP?

Seems like it would make sense that they would be billable tho, cuz you're making use of the doctor's time, or wasting it in the case of not showing up to your appointment

Why would they bill OHIP because a patient doesn't show up? That's coming from our tax money. That doesn't make any sense.

[aquariaguy]

Naturalpathic medicine are not covered by OHIP, since they have not been accepted into the main stream medicine yet, much like accupuncture. So yes, they have their own fee schedule. However, where I work, my extended health insurance covers it.

I went to the Robert Schad Naturopath School Clinic. Its the school clinic where 3rd and 4th yr students supervised by a Dr. sees you. Website: http://www.ccnm.edu/clinic/index.html

If you read their policies and goals, they are quite good and makes you feel a lot better than what general practicianers do in Ontario/Toronto.

They have their own shop that sells vitamins, but you can buy them anywhere at any drug store or natural food stores.


Will they ever become mainstream? I know my GP doesn't think highly of naturopathetic "herb" dealers hehe. And neither do some med. students ;)

[gordholio]

Two tier system.
One for the rich.
One for the poor.

Shouldn't be that way, but it is.

[royaljelly]

I have a lot of friends in the healthcare field (including MDs), some of which are GI physicians. The system of charging patients for a fee to get a faster procedure (particularly endoscopy) surprisingly is legit under the current OHIP system.

I believe the CPSO (College of Physicians & Surgeons) labels them as "Independent Health Facilities".

http://www.cpso.on.ca/Info_Public/factihf.htm

The specialist/secretary may not have mentioned to you that the typical wait times to get scoped is up to 6 months if done in the hospital, due to the lack of procedure times offered to the MDs. In order to expedite the services to patients, MDs are now setting up their own private endoscopy clinics and thus, are allowed to charge patients an additional "fee" either for administrative costs, sterilization of equipment, etc. In addition, they can also bill OHIP for the actual endoscopy procedure.

Here's a few private endoscopy clinics within the GTA:

http://www.markham-endoscopy.com/
(funny that they say there's no additional fee to the patient)

North Scarborough Endoscopy Inc
4040 Finch Avenue East,
Scarborough, ON M1S 4V5
Tel. : 416-293-9402

You can find more if you do a search on google maps under "endoscopy".

I also recall reading a story not too long ago about Toronto's private medical clinics for "Executives", whereby professionals pay thousands of dollars to get all the latest and greatest medical diagnostic tests under the sun to ensure tip top health. (eg: Toronto Executive Health Clinics).

MacLeans magazine has a great section on the breakdown of the different private medical servies offered in Canada:

http://www.macleans.ca/topstories/health/article.jsp?content=20060501_126226_126226

Is this considered 2 tiered health care in Canada? Absolutely. But it's not the first time it has happened in Canada, and as the health care system continues to be overstrained financially, privatized health care will slowly rear it's ugly head.

To the OP, hope that clears up your questions.

[aquariaguy]

Two tier system.
One for the rich.
One for the poor.

Shouldn't be that way, but it is.


You mean like the US? So you throw the poor on Medicaid and old people on MediCare, and than the rich can pay out of their pockets for the craziest ass expensive insurance.

Which is why there are like 45 million uninsured people in the US. Most of them are the "working poor." Middle class people who can't afford to insure everyone in their family. Not poor enough? Too bad. And there's approx. 15 million without "decent" insurance.

How would you like paying $200 a month for insurance, when you still have to pay a $100 deductible when you see a doctor?

[go leafs]

two-tier doesn't not mean US-style... look at European countries for examples, not the US.

[rfdrfd]

Thank you Royaljelly ! Extremely helpful. So I guess this GI Specialist is is doing exactly what you are saying.

He did mention to my relative that the wait will be like mid next year if they don't pay this $100 appointment.

Funny though, my friend with another GI Specialist did his endoscopy and only had to wait 2 months. But I guess like you said, each Dr. has its own schedules.



I have a lot of friends in the healthcare field (including MDs), some of which are GI physicians. The system of charging patients for a fee to get a faster procedure (particularly endoscopy) surprisingly is legit under the current OHIP system.

I believe the CPSO (College of Physicians & Surgeons) labels them as "Independent Health Facilities".

http://www.cpso.on.ca/Info_Public/factihf.htm

The specialist/secretary may not have mentioned to you that the typical wait times to get scoped is up to 6 months if done in the hospital, due to the lack of procedure times offered to the MDs. In order to expedite the services to patients, MDs are now setting up their own private endoscopy clinics and thus, are allowed to charge patients an additional "fee" either for administrative costs, sterilization of equipment, etc. In addition, they can also bill OHIP for the actual endoscopy procedure.

Here's a few private endoscopy clinics within the GTA:

http://www.markham-endoscopy.com/
(funny that they say there's no additional fee to the patient)

North Scarborough Endoscopy Inc
4040 Finch Avenue East,
Scarborough, ON M1S 4V5
Tel. : 416-293-9402

You can find more if you do a search on google maps under "endoscopy".

I also recall reading a story not too long ago about Toronto's private medical clinics for "Executives", whereby professionals pay thousands of dollars to get all the latest and greatest medical diagnostic tests under the sun to ensure tip top health. (eg: Toronto Executive Health Clinics).

MacLeans magazine has a great section on the breakdown of the different private medical servies offered in Canada:

http://www.macleans.ca/topstories/health/article.jsp?content=20060501_126226_126226

Is this considered 2 tiered health care in Canada? Absolutely. But it's not the first time it has happened in Canada, and as the health care system continues to be overstrained financially, privatized health care will slowly rear it's ugly head.

To the OP, hope that clears up your questions.

[thailion]

Hey guys,

I'm a medical resident, and have a few years under my belt as far as the profession goes.

First, to the OP: as stated a few posts earlier, what your GI specialist is doing is perfectly legit. Keep in mind, the GI doc will not make any more money by charging the extra $100, and most of these guys come in after clinic hours as a service to their patients. The $100 is actually LESS than what it costs to run an endoscopy session. The entire $100 will go towards overhead, with OHIP making up the remainder.

Make no mistake, this is "line-jumping", but the ethical burden lies in the hands of the patient making the decision, NOT the physician offering an expedited service. If you think a two-tier system is wrong, then you would sleep better if such a path was avoided. In all honesty, I would probably prefer to wait, but that's my own deal.

For those who lament the impersonal approach taken by their GPs, I SINCERELY APOLOGISE on behalf of all Family Docs. As a residency, Family Medicine is the easiest to get into, but also arguably the MOST difficult to do well. So for each resident that is busting his ass each night pounding the books, running research and really getting to know his patients during the day, there are three or four slackers who gave up shortly after they received their acceptance letter to medical school. And today those guys are practicing a watered-down version of "family medicine".

To the poster who wants to be looked after: True, your family doctor isn't your mom, but your mom likely hasn't read the latest data on cholesterol and anti-hypertensive medications, either. Your family doc also has learned specific behaviour modification techniques that will encourage you to excercise and quit smoking in ways that "you'll get fat" or "it's gross" never could (coming from your mom, that is).

Furthermore, it IS ABSOLUTELY the job of your family doc to know you inside and out (literally and figuratively; every man over 50 needs an annual digital rectal and every woman of child-bearing age needs an annual PAP and pelvic exam). It saddens me to hear that there are some who are not giving their patients the due time and respect, and if this is an issue, either bring it up with your GP, or find another one, preferably a younger grad who didn't go to med school during the cold war - and subsequently ended up a frigid old physician.

[rfdrfd]

Thank you, I appreciate your words. Thank you for sounding more professional in your comments too :)

So how do you think they came up with the $100 then ?



Hey guys,

I'm a medical resident, and have a few years under my belt as far as the profession goes.

First, to the OP: as stated a few posts earlier, what your GI specialist is doing is perfectly legit. Keep in mind, the GI doc will not make any more money by charging the extra $100, and most of these guys come in after clinic hours as a service to their patients. The $100 is actually LESS than what it costs to run an endoscopy session. The entire $100 will go towards overhead, with OHIP making up the remainder.

Make no mistake, this is "line-jumping", but the ethical burden lies in the hands of the patient making the decision, NOT the physician offering an expedited service. If you think a two-tier system is wrong, then you would sleep better if such a path was avoided. In all honesty, I would probably prefer to wait, but that's my own deal.

For those who lament the impersonal approach taken by their GPs, I SINCERELY APOLOGISE on behalf of all Family Docs. As a residency, Family Medicine is the easiest to get into, but also arguably the MOST difficult to do well. So for each resident that is busting his ass each night pounding the books, running research and really getting to know his patients during the day, there are three or four slackers who gave up shortly after they received their acceptance letter to medical school. And today those guys are practicing a watered-down version of "family medicine".

To the poster who wants to be looked after: True, your family doctor isn't your mom, but your mom likely hasn't read the latest data on cholesterol and anti-hypertensive medications, either. Your family doc also has learned specific behaviour modification techniques that will encourage you to excercise and quit smoking in ways that "you'll get fat" or "it's gross" never could (coming from your mom, that is).

Furthermore, it IS ABSOLUTELY the job of your family doc to know you inside and out (literally and figuratively; every man over 50 needs an annual digital rectal and every woman of child-bearing age needs an annual PAP and pelvic exam). It saddens me to hear that there are some who are not giving their patients the due time and respect, and if this is an issue, either bring it up with your GP, or find another one, preferably a younger grad who didn't go to med school during the cold war - and subsequently ended up a frigid old physician.

[thailion]

Thank you, I appreciate your words. Thank you for sounding more professional in your comments too :)

So how do you think they came up with the $100 then ?

I admit, that is a bit of a round number, when you consider all the things required in an endoscopy suite; the odds of the sum of all costs equalling an even $100 is very unlikely.

I never said the whole deal wasn't shady... just that it wasn't illegal.

:cheesygri

I can ask around the hospital, and hopefully one of our GI docs can offer an accurate answer.

[royaljelly]

In all honesty, I would probably prefer to wait, but that's my own deal.

Hi Thalion,

Just curious why you would say that when it comes to getting a diagnostic test faster?

Wouldn't you want to find out sooner what was the cause of your particular symptom(s) and not have to worry about it for months on end?

[rfdrfd]

I admit, that is a bit of a round number, when you consider all the things required in an endoscopy suite; the odds of the sum of all costs equalling an even $100 is very unlikely.

I never said the whole deal wasn't shady... just that it wasn't illegal.

:cheesygri

I can ask around the hospital, and hopefully one of our GI docs can offer an accurate answer.


Thanks, any luck on asking around?

[gman]

Hi Thalion,

Just curious why you would say that when it comes to getting a diagnostic test faster?

Wouldn't you want to find out sooner what was the cause of your particular symptom(s) and not have to worry about it for months on end?

Because of $100? Matter of principal?

[NLI10D]

I bet everyone that's calling out for a two-tier system are all for the most part healthy relatively young individuals. my grandmother 80+ goes thru a couple of Ks worth of meds each month and it is all covered by OHIP. she has a sister in Arizona and they have common meds, meds that are not covered by her sister's insurance and comes out of their own pocket. imagine if you need meds but cannot afford it since its not covered by your insurance, what will you do? its true that our healthcare system has alot of obvious flaws, but most of you that want to switch to a two-tier system only see the bad in our system and only the goods in the US system.

[go leafs]

I bet everyone that's calling out for a two-tier system are all for the most part healthy relatively young individuals. my grandmother 80+ goes thru a couple of Ks worth of meds each month and it is all covered by OHIP. she has a sister in Arizona and they have common meds, meds that are not covered by her sister's insurance and comes out of their own pocket. imagine if you need meds but cannot afford it since its not covered by your insurance, what will you do? its true that our healthcare system has alot of obvious flaws, but most of you that want to switch to a two-tier system only see the bad in our system and only the goods in the US system.

Two tier doesnt mean copying the US system... other developed nations (ex the european countries) have two tier systems; the US is not the one to emulate

[Bordello]

I'm all for public health care, but the government should start charging a minimal user fee (around $10-$20). That should help to weed out drug seekers and people who visit a doctor because they've had mosquito bites or a runny nose. Believe me, I see that happen everyday at the clinic I work at.

[jande9]

Doesn't surprise me.

When are people going to give up on this idea of a fully public healthcare system and start embracing a more efficient semi-private system?


I have lived in the UK, and my mother in law still lives there, and I have experience with the National health system. Their system covers all drugs plus all dental as well.

It is a public/private system.

The care you get is top notch, but they have way bigger problems than we do. The wait times are bad if you are public, but you can buy your way to the head of the line if you have money. Same doctor, same publicly funded hospital, same care, but if you pay, you get it a lot sooner. For instance, her knee operation can be done this week if she pays, but there is a 6 month wait if she doesn't. They leave the operating rooms empty to be available for private patients, and only slot in a certain amount of public patients a day.

My friend is a doctor over there and he says doctors are quitting left and right because the situation is so bad. Doctors are incredibly overworked and are not paid that well. A brain surgeon gets about 40,000 pounds a year from the govt as a salary (a few years ago), plus double that from his private patients. Family docs get way less.

In Canada there already is public private health care, because the doctors all work privately and the govt. only pays their fees. The govt is the single payer.

The real problem is when the govt. is also the health care provider, like in hospitals. The standard of care is changing so fast that the govt has real problems keeping up.

Our system is pretty efficient though. The US govt pays almost the same per`capita for health care as our govt does, and they only cover the elderly and the very poor. Our govt covers everybody.

[rfdrfd]

Update on the story. My relative went to the $100 paid Colonoscopy, and sadly the news is bad. Surgery is needed.

Last week, I saw my Family dr for other things and I asked him the same question. What is this $100 charge? He chuckled and said "well, yes, it is like a grey area. It is becoming very, very common that patients are asking for Colonscopy nowadays for various reasons. Each hospital only has a limited number of operating rooms for this examination, staff and hours of operation. So, each specialist gets a few dates. Which is obviously not enough to meet all the demands.

So, a lot of GI Specialists have opened up a Clinic and fitted it for Colonscopy, hired his own staff. Then, he offers that time slot to his patients. To off set some of those costs, he asks for $100 or whatever. $100 is up to the doctor. It could have been $200 or 300, its up to the patient if he/she thinks its worth it to get an appointment earlier."

He also says: "The average Colonscopy wait time is 3 months. Then, yes, the GI Specialist will also bill OHIP that he performed the Colonscopy. He may claim it under a different category, like "Block fees". Because even if he phones the patient, that is also claimable under OHIP."

My family dr. also says, a lot of Specialists are doing the same thing with Cateract (spelling?) surgeries.


So, bottom line, it isn't 100% illegal, but the GI Specialist is double dipping. OHIP can clamp down on it, but that would mean the wait time for Colonscopy would be long.

And it would be pretty bad in the case of my relative of finding out cancer 6 months later compared to 2 weeks ago.